MAIN STREET DENTAL OF KENYON PA – NPI #1700136116
Clinic/Center

MAIN STREET DENTAL OF KENYON PA is an AHC clinic located in KENYON, MN. NPPES has assigned the NPI number 1700136116 to MAIN STREET DENTAL OF KENYON PA on September 12, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 7 years ago on Jun 30, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MAIN STREET DENTAL OF KENYON PA below.

NPI Profile for
MAIN STREET DENTAL OF KENYON PA

NPI Number
1700136116
Enumeration Date

(about 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MAIN STREET DENTAL OF KENYON PA
Primary location
216 FOREST ST
KENYON, MN 55946
Phone: (507) 789-6815 Fax:
1 Other location(s):
2381 Rice St
Roseville, MN 55113-3715
Phone: (651) 235-6604
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DUY VU
DENTIST
Phone: (651) 235-6604
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 MN D12683

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.